CITY-COUNTY HEROIN, OPIOID, AND COCAINE TASK FORCE

200 E. Wells Street City of Milwaukee Milwaukee, Wisconsin 53202 Meeting Minutes CITY-COUNTY HEROIN, OPIOID, AND COCAINE TASK FORCE ALD. MICHAEL MURPHY, CHAIR Michael Lappen, Vice-Chair Karen Loebel, James Mathy, Ald. Khalif Rainey, Brian Peterson, Christine Westrich, E. Brooke Lerner, Marisol Cervera, Michael Macias, Ryan Shogren, Daniel Bukiewicz, and Jeanette Kowalik Staff Assistant, Chris Lee, 286-2232, Fax: 286-3456, clee@milwaukee.gov Legislative Liaison, Tea Norfolk, 286-8012 Friday, April 27, 2018 9:00 AM Room 301-B, Third Floor, City Hall 1. Call to order. Meeting convened at 9:05 a.m. 2. Roll call. Present 11 - Murphy, McManus, Rainey, Loebel, Westrich, Lappen, Lerner, Cervera, Macias, Mathy and Bukiewicz Excused 2 - Peterson and Shogren 3. Introduction of new members. Health Commissioner Dr. Patricia McManus and Mayor of Oak Creek Daniel Bukiewicz were introduced as new members to the task force. Commissioner Dr. McManus said that she is eager to learn. Mayor Bukiewicz said that the City of Oak Creek can add value to the task force, including its wake room. 4. Review and approval of the meeting minutes from February 9, 2018. Administrator Lappen moved approval, seconded by Atty. Loebel, of the meeting minutes from February 9, 2019. There was no objections. 5. City-County efforts, programs, initiatives, grants or activities. a. Allocation of $10,000 towards Take Back My Meds Milwaukee program. Chair Ald. Murphy commented. The TBMMM program works across the region to remove unused medicines, reduce access to those drugs, reduce use of those drugs for illicit purposes, and remove those drugs from the waterways. The City’s budget for this year was amended to allow $50,000 for prevention activities for the City and for City of Milwaukee Page 1 CITY-COUNTY HEROIN, OPIOID, AND Meeting Minutes April 27, 2018 COCAINE TASK FORCE task force recommendations. $10,000 is being allocated to the TBMMM program and will go to the City’s Common Council for approval. Community Advocates has been an important partner to the program. Individuals appearing: Atty. Jonathan Richards, TBMMM Coalition Director Kathy Schmitz, Medical Society of Milwaukee County Atty. Richards commented. TBMMM is a community organization made up of 16 groups dedicated to make it easier for Milwaukee County residents to take back their unused medicines. Main group participants are Community Advocates, Clean Wisconsin, Medical Society of Milwaukee County, Milwaukee Metropolitan Sewerage District (MMSD), and Sixteenth Street Community Health Centers. The two main program areas are increasing the number of fixed site year round drop box locations, especially at pharmacies, and doing an extensive public education campaign. Money is being raised for both projects both from the public and private sectors. MMSD has dedicated $15,000, and the City is dedicating $10,000. There is a grant application submitted to the Fund for Lake Michigan. Conversations are being made with the hospital system. Ms. Schmitz commented. The Medical Society was the first to support a drop box at Hayat Pharmacy last year. Drop boxes are an effective consumer oriented approach to remove unused medicines from homes. The money will be used efficiently and effectively for a communications plan, which will involve web sites, social media, and boots on the ground. Many audiences will be targeted such as hospitals, funerals, physicians, fire departments, and police departments. The coalition would like to come back to the task force to share results, including the number of people reached, number of drop box sites, and number of medicines collected. Administrator Lappen moved to recommend approval, seconded by Director Westrich, to allocate $10,000 from the City of Milwaukee towards the Take Back My Meds Milwaukee program. There was no objection. b. Milwaukee County Substance Abuse Prevention Coalition (MCSAP) introduction. Ald. Murphy said that the committee recognizes the great work that Community Advocates is doing through MCSAP and looks forward to partner with them with task force strategies going forward. Individuals appearing: Elysse Chay, Community Advocates Public Policy Institute Kari Lerch, Community Advocates Public Policy Institute Ms. Chay gave an overview and PowerPoint presentation. Her office staffs the MCSAP coalition. The coalition meets every other month and has more than 60 community members ranging from youth workers, community organizers, firefighters, to social workers. The goal of the coalition is to improve the quality of life in the community by preventing the harmful consequences of substance use and abuse among youth, families, and the community. The focus is on preventing youth marijuana use and prescription drug misuse. MCSAP is restricted to and gets funding for the first two prevention classifications: City of Milwaukee Page 2 CITY-COUNTY HEROIN, OPIOID, AND Meeting Minutes April 27, 2018 COCAINE TASK FORCE universal (target: general population and indirect/direct) and selective (target: population exposed to risk factors). The third prevention classification is indicated (target: for those already using and to prevent heavy or chronic use). Much funding is through Substance Abuse and Mental Health Services Administration (SAMHSA), and MCSAP goes through each of SAMHSA’s prevention framework steps of assessment, building capacity, planning, implementation, and evaluation every year. SAMHSA recommends the prevention strategies of information dissemination, education, providing drug-free alternatives, problem identification and referral, using community-based process, and environmental changes. One strategy that MCSAP is using regarding information dissemination is the use of the Wisconsin Dept. of Justice Dose of Reality campaign by putting up at flyers, posters, advertisements, or tabling events at universities (including Marquette University) and basketball games. For the universal indirect strategy, MCSAP has been working with installing permanent prescription drug take back boxes at several locations: Municipal Court, MPD Districts 2-7, suburban police departments, UW-Milwaukee and Marquette University, Hayat Pharmacy, and four Walgreens pharmacies. MCSAP also engages in take back awareness events, such as two upcoming events on April 28, 2018 and October 2018 sponsored by the Drug Enforcement Administration (DEA). There was on recent event occurred at two locations, with one on the north side and the other on the south side, on April 12, 2018 with the following partners: Children’s Community Health Plan, Skywalk Pharmacy, MPD, DEA, MFD, West Allis West Milwaukee Community Coalition, Founders3 Real Estate, and Hayat Pharmacy. MCSAP has been helping the TBMMM coalition by connecting with water quality advocates and community health organizations to change local policies that promote take back locations and events. MCSAP has been able to help purchase and distribute medicine lock boxes and bags, especially to senior centers in West Allis West Milwaukee. For the universal direct strategy, there is the Stay Strong MKE strategy where MCSAP provides funding, capacity building, and technical assistance to direct service organizations that focus on serving adolescents. Each organization is providing universal or selection prevention programming in different settings, including schools. Partners in 2018 include Diverse & Resilient, Neighborhood House, Neu-Life Community Development, The Parenting Network, Pathfinders, Running Rebels Community Organization, United Community Center, and West Allis/West Milwaukee Family Resource Center. MCSAP is working with Dr. Pace at the Medical College of Wisconsin in assisting her to create a presentation to educate prescribers on the dangers of overprescribing, opioid pain pills, and alternative options. MCSAP staffs the Alliance for Wisconsin Youth Southeastern Regional Prevention Center that is funded through the Wisconsin Department of Health Services. The role of the Alliance for Wisconsin Youth is to provide support and assistance to other coalitions in the greater southeastern Wisconsin region counties: Jefferson, Kenosha, Milwaukee, Ozaukee, Racine, Walworth, Washington, and Waukesha. Ald. Rainey and Administrator Mathy joined the committee at 9:19 a.m. and 9:21 a.m. respectively. MCSAP provides free substance abuse prevention skills training through the Alliance of Wisconsin Youth. The training is a 37-hour evidence-based course from SAMHSA City of Milwaukee Page 3 CITY-COUNTY HEROIN, OPIOID, AND Meeting Minutes April 27, 2018 COCAINE TASK FORCE that provides a broad orientation to the field of substance use prevention. Focus areas are behavioral health, the continuum of care, the public health approach, risk and protective factors, the development perspective, and the Strategic Prevention Framework. MCSAP provides suicide prevention gatekeeper training through Question, Persuade Refer (QPR). QPR can help people recognize the warning signs of a suicide crisis and how to question, persuade, and refer someone to help. MCSAP works with many groups from schools, youth agencies and others. MCSAP provides motivational interview training for grantees as a technique to change behaviors and help individuals to analyze their own goals and values; provides youth mental health first aid training to all people surrounding youths to support them if they have a mental health crisis; and provides drug identification training by law enforcement officers to education professionals, staff, nurses, and youth workers to recognize students who are under the influence and drug paraphernalia. MCSAP manages State Targeted Response (STR) funding to substance abuse prevention community coalitions within the counties of Jefferson, Ozaukee, Racine, Washington, and Waukesha as well as for South Milwaukee, and West Allis/West Milwaukee within Milwaukee County. MCSAP also provides STR support to the coalitions regarding to permanent drug take back boxes, lock bags/boxes, prescription drug deactivation units, Dose of Reality education materials, town hall meetings, and community events. The Public Policy Institute also does research and make recommendations. Copies are available to the committee concerning a draft opioid crisis report to state legislators on counties and law enforcement recommendations, opioid prevention brochures, and information on the drug drink lean. Ald. Rainey moved to enter documents, as referenced and submitted by Ms. Chay, into the record. There was no objection. Members inquired about programs against synthetic cannabis and lack of drop boxes in fire stations. Ms. Chay replied. All MCSAP programs delivered to young people are intended to cover all drugs and not specific to one drug or marijuana. Community Advocates also staff the City’s Tobacco Free Alliance, which addresses various tobacco products. Both MCSAP and the alliance are putting out information about the dangers of synthetic cannabis. There is understanding that substance abuse is a coping mechanism and that people need to find alternative coping mechanisms. Drop boxes are not in fire departments because fire departments are not meeting the level of security, 24 hours a day, that the DEA is looking for. Ald. Murphy further commented. Ald. Rainey had raised concern on the drug drink lean and that Safe and Sound is focusing on addressing lean. The issue about the lack of drop boxes in fire stations has been raised to the fire department. There is the take back envelope program, which was an initiative primarily from Ald. James Bohl, which is being expanded. Discussions are being made with CVS Pharmacy, and MMSD has agreed to expand the pilot program. The Milwaukee Fire Department (MFD) had issued Narcan in 3400 instances last year and produced surprising data broken down by aldermanic district and victims’ residences. Aldermanic districts 12 and 6 City of Milwaukee Page 4 CITY-COUNTY HEROIN, OPIOID, AND Meeting Minutes April 27, 2018 COCAINE TASK FORCE saw the highest rate of Narcan use incidents last year. The MFD data should be reviewed further by the committee. c. Other There was no other discussion. 6. Discussion with UnitedHealthcare on health insurance coverage. Ald. Murphy gave an update. Concerns were previously brought to the committee’s attention on the way UHC has made changes in providing its services. He had sent a follow-up letter, met with UHC representatives since the last meeting, and requested them to provide another written response. UHC submitted a response late yesterday, and copies are in members’ possession. UHC has agreed to appear in person at the next task force quarterly meeting for more discussion on the issue. 7. Review of initial work plan, next step strategies, and community input. Ald. Murphy commented. Work plan recommendations have been a long process. There have been some changes in task force membership and staffing issues, but the task force is back on track. Tiffinie Coggs from the Health Department had joined to work on the task force work plan and is doing a great job. Individual appearing: Tiffinie Cobb, Health Department Substance Abuse and Injury Prevention Manager Ms. Cobb gave an overview and PowerPoint presentation on the task force initial work plan. There are six categories of focus areas: education and prevention, treatment, justice system involvement, data, community collaboration, and policy. There were two community listening sessions with testimonies from stakeholders and residents last year. Focus areas include: enhance and fund existing prevention programs; reduce the number of opioid-related deaths; reduce the number of drug violation-related arrests; and ensure adequate access to timely, affordable, and quality services; develop programs in collaboration with the criminal justice system; enhance collaboration; improve epidemiology and surveillance; and support federal, state, and local policies and legislation. Next steps include community outreach through community workshop meetings to further develop initial plan strategies; aligning strategies with and identifying existing efforts, gaps, and needs; and leverage existing community resources. Workshop meetings will be designed with activities that go beyond the conversation, allow participants to identify tangible action items, and capture input from practitioners and those impacted. Partners are being identified to host the workshops. Workshops are to be representative of the whole county. The final work plan is anticipated for this fall and will include implementation strategies, roles, and responsibilities. The task force will be able to evaluate the community engagement component with its quarterly meetings. Ald. Murphy commented. The six categories of focus areas are all equally important and do not hold any particular priority over each other. Reaching out to the community is of significant importance. Anticipated are three community meetings countywide City of Milwaukee Page 5 CITY-COUNTY HEROIN, OPIOID, AND Meeting Minutes April 27, 2018 COCAINE TASK FORCE over the spring and summer. The community sessions should not require members to attend, but they are encouraged to do so. Several members have contributed to the initial work plan, and they are to be commended. Administrator Lappen said that staff from Behavioral Health Division and others are encouraged to circulate the initial work plan to provider networks for broad feedback and publicize resources to the community. 8. Set next meeting date and time. The next quarterly task force meeting anticipated for July. 9. Agenda items for the next meeting. To be determined. Members are to forward agenda items to clerk staff and chair Ald. Murphy 10. Adjournment. Meeting adjourned at 9:40 a.m. Chris Lee, Staff Assistant Council Records Section City Clerk's Office This meeting can be viewed in its entirety through the City's Legislative Research Center at http://milwaukee.legistar.com/calendar. City of Milwaukee Page 6